Perceptiviti's Sherlock Platform

Summary

Perceptivity's Sherlock Platform is a cutting-edge AI solution revolutionizing health claim processing for insurers. By automating and digitizing claims, it reduces processing time from hours to minutes, saving time and money while preventing fraud. The suite includes IPA for document digitization, I-10 coder for diagnosis coding, Sherlock AI for claim evaluation, and Newton for KPI management. It has saved insurers millions, ensuring fair, fast, and accurate insurance processes.

Takeaways

• 🧠 Sherlock is a state-of-the-art AI platform for insurers.
• 🚑 It automates health claim processing, reducing processing time significantly.
• 💰 Sherlock helps insurers save money by eliminating fraud, waste, and abuse.
• 📚 The suite includes four products: Sherlock IPA, I-10 Coder, Sherlock AI, and Newton.
• 🔍 Sherlock IPA digitizes claims and flags potential pre-existing diseases and non-payable items.
• 📈 I-10 Coder converts free text diagnosis information into standard ICD-10 codes.
• 🤖 Sherlock AI evaluates claims against six significant dimensions and scores them for deniability.
• 🔎 It uses advanced network graph analysis to identify potential fraud through aberrant relationships.
• 📊 Newton provides KPI management and advanced analytics to turn data into insights.
• 🌐 Sherlock has helped insurers worldwide save millions in healthcare abuse.
• 🛡️ It ensures insurance fairness, speed, and accuracy through deep technology.

Q & A

What is the primary function of the Sherlock platform?

The Sherlock platform is an artificial intelligence system designed to automate health claim processing for insurers, reducing the time from hours and weeks to minutes.

How does Sherlock help in critical moments for patients, hospitals, and insurers?

Sherlock saves precious time by quickly processing health claims, which is crucial for patients needing timely treatment and for hospitals and insurers managing resources efficiently.

What are the financial benefits of using the Sherlock platform?

Sherlock helps save money by eliminating fraud, waste, and abuse in the health claim process, potentially saving insurers millions of dollars.

What are the four products included in the Sherlock suite?

The Sherlock suite comprises Sherlock IPA, which digitizes claims; I-10 Coder, which converts diagnosis information to ICD-10 codes; Sherlock AI, an advanced AI/ML platform for evaluating claim data; and Newton, which provides KPI management and advanced analytics.

How does Sherlock IPA contribute to the claim processing?

Sherlock IPA digitizes unstructured printed documents like discharge summaries into structured information, identifies potential pre-existing diseases, and flags deductible and non-payable items.

What is the role of I-10 Coder in the Sherlock suite?

I-10 Coder takes free text diagnosis information and converts it into standard ICD-10 codes, which are essential for accurate claim processing.

What capabilities does Sherlock AI possess in evaluating claim data?

Sherlock AI evaluates captured claim data against six significant dimensions and scores each claim on its deniability, using advanced network graph analysis to identify potential fraud.

How does Newton assist in the claim processing system?

Newton provides out-of-the-box KPI management and advanced analytics capabilities, converting data captured throughout the process into useful insights for better decision-making.

What has been the impact of the Sherlock suite on insurers worldwide?

The Sherlock suite has helped insurers worldwide save millions of dollars in healthcare abuse while ensuring that genuine patients receive their claims instantaneously.

How does the Sherlock platform ensure insurance fairness, speed, and accuracy?

Sherlock ensures insurance fairness, speed, and accuracy through deep technology, including AI/ML algorithms and network graph analysis, which streamline the claim processing and detect fraudulent activities.

What action can one take if they want to learn more about the Sherlock platform or see a demo?

If interested in learning more or seeing a demo of the Sherlock platform, one should contact the company directly as mentioned in the script.